Aromatase Inhibitors (AIs) are recommended for survival in post-menopausal breast cancer survivors (BCS) with hormone-sensitive disease. AI Adherence is suboptimal, especially in older BCS. Joint pain is a common AI-related symptom that is associated with low AI adherence. The Using Exercise to Relieve Joint Pain in Older Breast Cancer Survivors (REJOIN) Trial will evaluate the efficacy of a self-management intervention (exercise + education) to increase knowledge/self-efficacy for symptom management, reduce joint pain and potentially increase AI adherence in older BCS planning to take AIs.
This randomized controlled pilot trial will include sedentary BCS, 65 years and older, diagnosed with stage I-III hormone-sensitive breast cancer, who have completed primary cancer treatment and are planning to initiate AIs. We will adapt an evidence-based physical activity program for older adults that includes bi-weekly, supervised exercise sessions plus 30 min of education. The 16-week intervention program includes 8-weeks of supervised sessions plus 8-weeks of self-guided home sessions with periodic phone coaching. We will conduct geriatric assessments plus measurements of exercise, joint pain, and AI adherence (baseline, 4, 6 and 12 months).
REJOIN is one of the first trials to exclusively target older BCS using a self-management intervention, informed by geriatric assessment and exercise physiology, to improve health outcomes in survivorship. The REJOIN trial could lay the foundation for transdisciplinary research that bridges the gap between clinical and public health perspectives in healthy aging, with the opportunity to translate clinical interventions into non-pharmacological tools for a growing, yet underserved population of older survivors.
NCT03955627.
NCT03955627.Advance care planning (ACP) allows patients to acknowledge and document their preferences regarding end-of-life care and to ensure their fulfilment. Several factors were found to be related to patients' motivation regarding this process, such as their fear of being a burden on family members; however, the completion rate of the ACP forms is partial. The current study aimed to evaluate the barriers and motives among Israeli cancer patients regarding ACP, including many older adults.
Advanced cancer patients participated in the study. All completed an initial questionnaire to evaluate their basic knowledge regarding the issue. Participants who agreed to talk with a social worker completed a semi open-ended questionnaire which investigated their main motives and barriers regarding the issue.
Most of the patients who completed the ACP forms were older and had lung cancer. They mentioned information and open communication with family and staff members as the main enabling factors. Their main motives were to ensure that the best medical decisions would be made and to avoid unnecessary medical procedures. The main reasons for not completing the forms was no close relative who would agree to take the responsibility as well as timing. https://www.selleckchem.com/products/resatorvid.html Most of the participants did not hear about the issue from sources outside the oncology division.
Despite several limitations, the current findings may have important implications regarding ways to establish a more suitable ACP process, adjusted to older patients' needs. This may assist in promoting patients' cooperation with ACP and its implementation in the medical system, including older adults.
Despite several limitations, the current findings may have important implications regarding ways to establish a more suitable ACP process, adjusted to older patients' needs. This may assist in promoting patients' cooperation with ACP and its implementation in the medical system, including older adults.Chlorhexidine gluconate is currently the most effective oral antimicrobial agent against microorganisms, but discoloration of the teeth prevents its long-term use and can reduce patient cooperation. In this study, the effect of chlorhexidine and a diluted chlorhexidine-based, fluoride, cetylpyridinium and vitamin added mouth rinse (Orthokin) on stain index in fixed orthodontic patients was compared.
This study was performed as a double blind randomized controlled trial on 50 patients undergoing fixed orthodontic treatment in the age group of 14-30 years. The patients were categorized as two groups of chlorhexidine and Orthokin mouth rinses and were asked to use mouthwash for eight weeks. Groups were matched according to colouring food consumption. Extrinsic staining index was assessed by modified Loben technique. Data was analysed by SPSS software. P value was set to be 0.05.
In the chlorhexidine group, the stain extent index and overall stain index were increased significantly at 8 weeks (P&lt;0.001 and P=0.002, respectively). However, the increase in stain intensity index was insignificant (P=0.07). In Orthokin group, the changes in stain extent, stain intensity and overall stain were insignificant (P=0.66, P=1.000, P=0.47, respectively).
According to the results of the present study, chlorhexidine mouthwash causes more staining of teeth compared to Orthokin mouthwash. It seems that lower concentrations of chlorhexidine can be prescribed to orthodontic patients. Although these compounds are effective in sense of oral hygiene, they do not cause significant discoloration.
According to the results of the present study, chlorhexidine mouthwash causes more staining of teeth compared to Orthokin mouthwash. It seems that lower concentrations of chlorhexidine can be prescribed to orthodontic patients. Although these compounds are effective in sense of oral hygiene, they do not cause significant discoloration.Public policy measures and clinical risk assessments relevant to COVID-19 need to be aided by risk prediction models that are rigorously developed and validated. We aimed to externally validate a risk prediction algorithm (QCovid) to estimate mortality outcomes from COVID-19 in adults in England.
We did a population-based cohort study using the UK Office for National Statistics Public Health Linked Data Asset, a cohort of individuals aged 19-100 years, based on the 2011 census and linked to Hospital Episode Statistics, the General Practice Extraction Service data for pandemic planning and research, and radiotherapy and systemic chemotherapy records. The primary outcome was time to COVID-19 death, defined as confirmed or suspected COVID-19 death as per death certification. Two periods were used (1) Jan 24 to April 30, 2020, and (2) May 1 to July 28, 2020. We assessed the performance of the QCovid algorithms using measures of discrimination and calibration. Using predicted 90-day risk of COVID-19 death, we calculated rvalues, Brier scores, and measures of discrimination and calibration with corresponding 95% CIs over the two time periods.